Hypo/hyperthermia

Question 1

Normal body temperature

Answer 1

36.5-37.5

Question 2

Risk factors for hypothermia

Answer 2

Extremes of age
Malnourished
Trauma
Hypothyroidism
Intoxication
Mental impaired,ent
Cold water immersion

Question 3

In which temp is shivering lost

Answer 3

24-35

Question 4

What the lethal triad

Answer 4

Hypothermia
Coagulopathy
Acidosis

Question 5

ECG changes in hypothermia

Answer 5

Bradycardia
Osborn waves
Prolonged PR, QRS and QT interval
Atrial fibrillation
Ventricular fibrillation
Shivering artefact
Asystole

Question 6

Management of hypothermia

Answer 6

ABSs
Remove wet clothes
Handle gently to prevent cardiac arrhythmias
Core temp and continuous cardiac monitoring
Passive and Active rewarding: passive is for dry patients and active is for wet (Passive with blankets and warm environment, active with warmed blankets, , heaters, warm fluids alongside pt and in the ground and armpits, active core with humidified O2, IV warm fluids, bladder lavage, peritoneal lavage, gastric lavage, left pleural lavage, cardio bypass in extreme cases )

Question 7

What features warrant stopping rescusc in a patient with hypothermia

Answer 7

Ph <6.5, Temp <7 or <15 with no ROSC for >2h, K>10

Question 10

Heat exhaustion vs heat stroke

Answer 10

Heat exhaustion

Heat stroke

Heat exhaustion
Mild-mod dehydration, temp <40°C, no CNS signs
Heat stroke
Temp >40°C with altered mental status

Question 11

Classification or heat stroke

Answer 11

Exertional: athletes (prolonged exposure to heat/sun on exertion
Classical/non exertional: exposure to heat (sun, hot water) for a prolonged period
body heat gain exceeds body heat loss

Question 12

Diagnosis heat stroke

Answer 12

1. Core temp (rectal) 40 or above
2. CNS abnormality : LOC, confusion, coma
3. Myth that pt stops sweating (not true)

Question 13

Management of heat stroke

Answer 13

Remove pt from heat source
Cool the patient (to 38)
-warm water mist + airflow (prevents vasoconstriction and shivering, causes heat loss by evaporation )
-ice packs to the core (groin, axillar, armpits)
-cool water immersion (exertional) 1 degree every 5min
-cool IV fluid
-

Question 14

Symptoms and signs of heat stroke

Answer 14

High temperature
Hot red, dry or damp skin
Fast strong.pulse
Nausea and vomiting
Headache
Fainting
Dizziness
Confusion
Loss of consciousness

Question 16

Symptoms and sighs of heat exhaustion

Answer 16

Heavy sweating
Cold, pale clammy skin
Fast weak pulse
N and V
Muscle cramps
Weakness
Dizzziness
Headache
Fainting